| NPI | 1932580388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 29639) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NE 29639) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2023-10-10 |